Reporting Primary Prescription Coverage Mandatory January 2020

The Centers for Medicare & Medicaid Services (“CMS”) has issued new guidance on Medicare Secondary Payer (“MSP”) reporting requirements in response to the SUPPORT for Patients and Communities Act enacted on October 24, 2018.

Currently, Responsible Reporting Entities (“RREs”) of group health plans are required to report information to CMS about individuals who are entitled to Medicare. The reporting process includes the option to exchange primary prescription drug coverage information to coordinate benefits related to Medicare Part D. This information enables CMS to determine whether a plan is primary or secondary payer to Medicare. This voluntary submission of information will soon become mandatory beginning January 1, 2020.

RREs that have been submitting primary prescription drug coverage information will continue to do so, but RREs that have not been reporting this information should consult the User Guide for instructions. CMS released FAQs  for more information on this reporting requirement. Check out ComplianceDashboard to learn much about complying with Medicare!


The information and content contained in this blog post are for general informational purposes only, and does not, and is not intended to, constitute legal advice.

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